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General NPI Number Information
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NPI Number | 1295230647
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Entity Type | Individual
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Provider Name | JEFFREY CROSS MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2018
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 2373 64TH ST SW STE 2700
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City | BYRON CENTER
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State | MI
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Zip | 49315-7978
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Country | US
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Telephone | 616-465-5910
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Fax | 616-465-5911
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Provider Business Mailing Address
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Address Line | 75 FRANCIS ST
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City | BOSTON
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State | MA
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Zip | 02115-6110
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Country | US
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Telephone | 617-732-5500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301511747
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License Number State | MI
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